(Select All That Apply): A nurse is assessing a client for major depressive disorder (MDD). Which of the following signs and symptoms are consistent with the clinical presentation of MDD? Select all that apply.

Choice A rationale:

Bipolar disorder involves both depressive episodes and manic episodes. The client in question denies any history of manic episodes, making bipolar disorder less likely as a diagnosis. Manic episodes are characterized by elevated mood, increased energy, impulsivity, and risky behavior.

Choice B rationale:

Dysthymia, also known as persistent depressive disorder, involves chronic feelings of sadness and a lack of interest or pleasure in activities. It is a milder form of depression that persists for at least two years in adults. The client's persistent feelings of sadness align more closely with the criteria for dysthymia.

Choice C rationale:

Substance-induced mood disorder occurs when the client's mood disturbances are a direct result of substance use or withdrawal. Since there is no mention of substance use or withdrawal in the client's history, this choice is less relevant to the scenario.

Choice D rationale:

Adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressor, and these symptoms typically resolve within six months of the stressor's resolution. In the scenario, there is no indication of a recent stressor, and the client's symptoms seem to be chronic rather than time-limited, making adjustment disorder less likely.

Choice A rationale:

The correct answer. A positive family history of mood disorders is a well-established risk factor for developing major depressive disorder (MDD). Genetic factors play a significant role in predisposing individuals to MDD, making it more likely to develop if there's a family history of mood disorders.

Choice B rationale:

Optimistic personality traits are not considered risk factors for developing major depressive disorder (MDD). In fact, having an optimistic personality might serve as a protective factor against developing MDD.

Choice C rationale:

The correct answer. Young age is a risk factor for developing MDD. Adolescents and young adults are particularly susceptible to the onset of depressive disorders due to hormonal changes, emotional challenges, and life transitions during this developmental stage.

Choice D rationale:

High socioeconomic status is not a consistent risk factor for developing major depressive disorder (MDD). While individuals from various socioeconomic backgrounds can develop MDD, the factors contributing to its development are more complex and not solely dependent on socioeconomic status.

Choice E rationale:

The correct answer. Chronic medical conditions are risk factors for developing major depressive disorder (MDD). The stress, emotional toll, and physiological effects of living with a chronic illness can contribute to the onset or exacerbation of depressive symptoms.